Migraine Medications (cont.)
Gary D. Vogin, MD
Dr. Vogin is a board-certified general internist, having completed his residency in internal medicine at Temple University Hospital in Philadelphia in June 1994. Before deciding on internal medicine, Vogin prepared for a career in pathology and was Outstanding Transitional First Year Graduate at St. Barnabas Medical Center in Livingston, N.J., in 1991.
In this Article
- For what conditions are migraine medications used?
- What are the different types of migraine medications?
- What are the side effects of migraine medications?
- What are the warnings and precautions with migraine medications?
What are the warnings and precautions with migraine medications?
In 2006, the FDA warned about combining triptan drugs with selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). Taking the drugs together could result in an overload of serotonin in the body, creating what is known as the "serotonin syndrome.” Symptoms of this life-threatening condition include rapid increase in blood pressure, fast heart beat, and increased body temperature.
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Fluvoxamine (Luvox)
- Olanzapine/fluoxetine (Symbyax)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
Ergot alkaloids should not be used concurrently with drugs that inhibit a certain liver enzyme. Doing so could result in a life-threatening decrease in blood flow to the extremities and/or brain. These drugs include:
- Macrolide antibiotics such as erythromycin (Benzamycin, Emgel, Ilotycin), clarithromycin (Biaxin, Biaxin XL), and troleandomycin (Tao)
- HIV protease inhibitors such as ritonavir or indinavir
- Azole antifungals such as ketoconazole
Use of topiramate (Topamax) can result in decreased sweating and increased body temperature. This may be especially important during hot weather. Wearing light clothes and drinking plenty of fluids while using topiramate during warmer months is very important. A physician should be consulted if body temperature rises.
American Headache Society (www.AmericanHeadacheSociety.org)
National Migraine Association (www.migraines.org)
National Headache Foundation (www.headaches.org)
Medline Plus (www.nlm.nih.gov/medline)
Annals of Allergy, Asthma and Immunology, 9 January 2006 (found on www.researchgate.net)
Migraine Research Foundation (www.migraineresearchfoundation.org)
Food and Drug Administration (www.fda.gov)
Kaiser Permanente Drug Encyclopedia (www.kaiserpermanente.org)
Last Editorial Review: 8/17/2009
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